Refresh Your Knowledge of Neurology

[GinniferLynne]

Okay,

I know this has been repeated a million, if not billion times, but I am going to do it anyway: (mostly for my own sanity -hopefully helping a few others along the way)

First of all, tonight while at Borders Books, I, of course, headed back to the medical reference section and found a brand new copy of Victors and Adams Principles of Neurology 2005 Updated Version.

Under als a quote that put a smile on my face: "Fasciculations soley almost never present as a manifestation of ALS, this is a clinical truism which has been told to many medical students and physicians with fasiculations who are scared that they may be at beginning of this disease"

(I may have one or two words out of order, but this was the basic quote that I memorized) - The book cost $150.00 - I wasn't about to buy it.

Anyway, I then went to a neuroscience principle book which stated that in the exceptionally rare case of someone presenting with fasiculations alone, most were found to have a slight clinical weakness that in just a few weeks or month, the patient themselves would most certainly become aware of.

I am writing this so it will go into our archives and (selfish one that I am), I can refer to this when I start to wig out.

Ginny

 

[Diego4Life]

Love it Ginny!

Lets repeat it again, "Fasciculations soley almost never present as a manifestation of ALS, this is a clinical truism which has been told to many medical students and physicians with fasiculations who are scared that they may be at beginning of this disease"

I am sure if we say this enough times we will re-programme our heads eventually!! I still angst about als and have had calf fasciculations for 10 years.

Thanks for the post.

Diego4Life

 

[Diego4Life]

I had to add a bit more to the above to drive this point home. The quote from the principles of neuroscience book I found so reassuring, states that in 'the exceptionally rare case of a Pt presenting with only fasciculations, would have a slight clinical weakness that they would become aware of within a few weeks to a month' Not months or years???

Again, I am fairly sure that even a slight weakness would be picked up by a neurologist in and exam. They do these tests every day, its their bread and butter. I am a chiropractor and I perform orthopedic and neurological tests every day and even I can pick up weakness and believe me it is noticeable.

I had a very good freind with a prolapsed intervertebral disc. He didn't know he had this problem at the time. His presenting symptoms were low back pain, sciatica and guess what??? Bilateral fasciculations in his calves and feet! He said that he could not perform the heel toe walk and when he was asked to come up onto his left toes, he fell sideways, his calf unable to support the weight. That is muscle weakness.

The point that I am trying to make is that weakness is detectable and let's not forget that the disease many of us fear is relentlessly progressive, therefore the weakness would be progressive and as the quote from the book says, within weeks to a month noticeable to the patient. This concurs within every piece of research I have read on the subject. Weakness is the main presenting symptom and fasciculations are a secondary symptom caused by the muscle dying and giving off fascics.

 

[DJohnDavies]

Ginny,

That was a great, great post. Thanks so much for reading that textbook and for sharing that with us!

Johnny